Articulating endoscopic surgical apparatus

ABSTRACT

A surgical instrument is provided for use in endoscopic or laparoscopic surgery. The instrument includes a handle portion and an endoscopic portion. The endoscopic portion has an elongated tubular section having opposed proximal and distal ends, the proximal end of which extends from the handle portion, and an articulating section which is pivotally connected to the tubular section adjacent the distal end thereof. Tool means depend from the articulating section and a linkage mechanism is associated with the endoscopic portion for pivoting the articulating section relative to the longitudinal axis of the tubular section, within a 90° sector of rotation. In addition, the instrument includes means for rotating the endoscopic portion about its longitudinal axis.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The subject invention relates to surgical apparatus for performinglaparoscopic and endoscopic surgical procedures, and more particularlyto apparatus having an end portion which can be articulated in apatient's body during a surgical procedure.

2. Description of Related Art

In laparoscopic and endoscopic surgical procedures a small incision orpuncture is made in the patient's body to provide access for a tube or acannula device. Once extended into the patient's body, the cannulaallows insertion of various surgical instruments such as scissors,dissectors or retractors to perform the surgery.

An example of an endoscopic surgical instrument is illustrated in U.S.Pat. No. 2,113,246 which issued to Wappler on Apr. 5, 1938. This patentdiscloses endoscopic forceps comprising an elongated conduit with jawsat the distal end thereof, a control rod in the conduit for controllingthe operation of the jaws, and a control handle at the proximal end ofthe conduit which is operatively connected to the control rod. Thissurgical instrument is extremely limited in its application in that theangle of the conduit portion mounting the jaws cannot be adjusted inrelation to the remaining portion of the conduit during a surgicalprocedure.

Improvements have been made in the art of surgical instruments toincrease their range of operability. For example, U.S. Pat. No.4,763,669 which issued to Jaeger on Aug. 16, 1988 discloses amicrosurgery instrument with an adjustable angle of operation forobtaining cervical biopsies.

Similarly, U.S. Pat. No. 4,880,015 which issued to Nierman on Nov. 14,1989 discloses a surgical device having an increased range ofoperability. In particular, this patent shows a biopsy forceps designedfor use through a flexible fiberoptic bronchoscope. The biopsy forcepsincludes a handle connected to a thin elongated flexible shaft with adistal portion thereof hinged to the shaft. A grasping tool or biopsyforceps is attached to the distal hinged portion. Control wires extendfrom the handle to the distal end to the shaft for controlling theangular rotation of the distal portion of the instrument.

Of the references discussed above, none of these instruments disclose alaparascopic instrument for insertion into a body cavity through acannula and adapted for a wide range of laparascopic surgicalapplications. Further, the instruments disclosed therein are notprovided with means for rotating the tool head about the longitudinalaxis of the endoscopic portion of the instrument. Instead, a surgeonusing either of these prior art instruments must physically rotate theentire instrument in order to change the rotational orientation of thedistal end of the conduit or tube.

Accordingly, it is an object of the subject invention to provide anendoscopic surgical instrument having a tool head which is independentlymoveable about two axes of rotation relative to the handle while theinstrument is in use.

It is another object of the subject invention to provide a lightweightendoscopic surgical instrument which can provide a clearer line of sightfor a surgeon during a surgical procedure.

It is still another object of the subject invention to provide anendoscopic instrument in which a wide variety of different tool headsmay be employed.

It is yet another object of the subject invention to provide anendoscopic instrument which may be used to perform electrocauterizationduring surgical procedures.

Another object of the subject invention is to provide an endoscopicinstrument which is inexpensive to manufacture.

These and other objects of the subject invention will be made moreapparent from the following description taken in conjunction with theaccompanying drawings.

SUMMARY OF THE INVENTION

An endoscopic surgical instrument is disclosed for use in a wide varietyof roles including grasping, dissecting, clamping, or retractingmaterials or tissue during surgical procedures performed within apatient's body and particularly within the abdominal cavity.

The surgical instrument of the subject invention includes a handleportion having a fixed handle, and an endoscopic portion which dependsfrom the handle portion. The endoscopic portion includes an elongatedtubular section and an articulating section which is pivotally connectedadjacent to the distal end of the tubular section. Tool means areoperatively connected to the articulating section of the endoscopicportion. A linkage mechanism is associated with the endoscopic portionof the instrument for selectively pivoting the articulating section inan angular plane relative to the longitudinal axis of the tubularsection within about a 90° sector of rotation. This linkage mechanism ispreferably controllable from the handle portion of the instrument.

In a preferred embodiment of the subject invention, the surgicalinstrument may include a handle portion having a fixed handle and apivoting handle. A cable extends from the pivoting handle through theendoscopic portion to the tool means. In this embodiment, the tool meansmay comprise a pair of cooperating jaws, the movement of which iscontrolled by operating the pivoting handle.

The linkage mechanism for pivoting the articulating section of theendoscopic portion preferably may include an elongated push rodextending from the handle portion, through the endoscopic portion. Thepush rod would be connected to a link member, which, in turn may bepivotally connected to the articulating section of the endoscopicportion. In addition, the linkage mechanism may include a reciprocatingmember having a gear rack disposed adjacent the handle portion of theinstrument in cooperation with the proximal end of the elongated pushrod. The gear rack member would be movable in an axial direction inresponse to rotation of an annular pinion gear in the handle portion ofthe instrument. Rotation of the pinion gear would cause the gear rackmember to translate coaxially, causing the push rod to move, and therebycausing the articulating section of the endoscopic portion to pivotwithin a 90° sector of rotation relative to the longitudinal axis of theendoscopic portion of the instrument.

Preferred embodiments of the subject invention may also include meansfor rotating the endoscopic portion of the surgical instrument about thelongitudinal axis thereof. In this instance, an annular bushing, whichmay be concentrically disposed within an annular cuff, would be providedin the handle portion of the instrument. The proximal end of theendoscopic portion of the instrument would be arranged within thebushing and would be rotatable about its longitudinal axis by rotatingthe annular cuff.

In an alternate embodiment of the subject invention, the surgicalinstrument may include a handle portion configured as a pistol-grip andan endoscopic portion including an elongated fixed tubular section whichdepends from the handle portion and an articulating section pivotallyconnected to the fixed section adjacent the distal end thereof. Anelongated paddle tool would depend from the articulating section of theendoscopic portion for performing retraction tasks during surgicalprocedures. In addition, a linkage mechanism would be associated withthe endoscopic portion of the instrument for pivoting the articulatingsection relative to the longitudinal axis of the fixed section, within a90° sector of rotation. The instrument could also be provided with meansfor rotating the endoscopic portion thereof about its longitudinal axis.

Further features of the subject invention will become more readilyapparent from the following detailed description of the invention takenin conjunction with accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

Preferred embodiments of the subject invention will be describedhereinbelow with reference to the drawings, wherein:

FIG. 1 is a perspective view of an articulating endoscopic surgicalinstrument in accordance with a preferred embodiment of the subjectinvention;

FIG. 2 is an exploded view of the articulating endoscopic surgicalinstrument of FIG. 1;

FIG. 3 is a side cross-sectional view taken along line 3--3 of FIG. 1illustrating the handle portion of the endoscopic surgical instrument;

FIG. 4 is a side cross-sectional view taken along line 4--4 of FIG. 1illustrating the distal end of the endoscopic surgical instrument;

FIG. 5 is a top plan view cross-section view taken along line 5--5 ofFIG. 4;

FIG. 6 is a side cross-sectional view of the distal end of theendoscopic surgical instrument showing the jaws in a closed position;

FIG. 7 is a side cross-sectional view showing, in solid and in phantomlines, the various pivoting movements of the articulating section of theendoscopic portion of the surgical instrument shown in FIG. 1.;

FIG. 8 is an enlarged side cross-sectional view of the distal end of theendoscopic surgical instrument taken along line 8--8 of FIG. 7;

FIG. 9 is an enlarged side cross-sectional view of the handle portion ofthe endoscopic surgical instrument illustrating the various positions ofthe pinon gear which comprises a portion of the linkage mechanism of thesubject invention;

FIG. 10 is a front cross-sectional view taken along line 10--10 of FIG.9;

FIG. 11 is a side cross-sectional view illustrating an alternateembodiment of the tool head of the endoscopic surgical instrument of thesubject invention in an open position;

FIG. 12 is a top cross-sectional view taken along line 12--12 of FIG.11;

FIG. 13 is a side cross sectional view of the tool head shown in FIG. 11in a closed position;

FIG. 14 is a side cross-sectional view showing, in solid and in phantomlines, the pivotal movements of the articulating section of theendoscopic portion of the subject invention with the alternateembodiment of the tool head shown in FIGS. 11-13;

FIG. 15 is a front cross-sectional view taken along line 15--15 of FIG.14;

FIG. 16 is a perspective view of an alternate embodiment of the subjectinvention which includes an articulating paddle for performingretraction tasks;

FIG. 17 is a side cross-sectional view taken along line 17--17 of FIG.16;

FIG. 18 is a side cross-sectional view taken along line 18--18 of FIG.16;

FIG. 19 is a side cross-sectional view taken along line 17--17 of FIG.16;

FIG. 20 is a perspective view of another embodiment of the articulatingendoscopic surgical instrument of the subject invention; and

FIG. 21 is an exploded view of the articulating endoscopic surgicalinstrument of FIG. 20.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The articulating endoscopic surgical instrument of the subject inventionis illustrated in FIG. 1 and is designated generally by referencenumeral 10. Surgical instrument 10 comprises a handle portion 12including a fixed handle 14 and a pivoting handle 16. An endoscopicportion 18 extends orthogonally from handle portion 12 and includes anelongated fixed tubular section 20 and an articulating section 22. Thearticulating section 22 is pivotally connected to the fixed section 20by a pin 24 disposed adjacent the distal end 26 of section 22. A toolhead 28 having cooperating jaws 30, 32 depends from the articulatingsection 22 and may be formed in a wide variety of configurationsincluding graspers, dissectors, or clamps.

Turning to FIG. 2, the handle portion 12 and the associated fixed handle14 comprises complimentary sections 34 and 36 which are mounted to oneanother by a plurality of bosses 38 formed on section 34. The pluralityof bosses 38 are arranged for engagement in corresponding apertures (notshown), which are formed in section 36 of handle portion 12. Inaddition, each of the complimentary sections 34, 36 of handle portion 12are formed with a portion of a stepped bore 40 which is provided thereinfor accommodating various components of the subject invention, all ofwhich will be described in greater detail hereinbelow. Stepped bore 40includes a circumferential flange 41 for securing the tubular section 20of endoscopic portion 18 in handle portion 12.

The fixed tubular section 20 of endoscopic portion 18 is formed with alongitudinal slot 42 extending proximally from the distal end 26thereof. Slot 42 is particularly adapted for enabling the pivotalmovement of articulating section 22 about pivot pin 24. An aperture 44is provided adjacent distal end 26 for maintaining the pivot pin 24.Pivot pin 24 is provided with a transverse diverging bore hole 25, whichis best seen in FIG. 4. A circumferential groove 45 is formed in thetubular section 20 adjacent the proximal end 27 thereof for enablingtubular section 20 to be securely mounted in the stepped bore 40 ofhandle portion 12.

The tool head 28 which depends from articulating section 22 includescooperating jaws 30, 32, shown here in a clamp configuration. Jaws 30,32 pivot about a pin 46 which passes through apertures 48, 50 in jaws30, 32, respectively and through aperture 52 formed in articulatingsection 22. Jaws 30, 32 also include camming slots 53, 54 respectivelyformed in the proximal ends thereof for receiving a camming pin 55. Pin55 is mounted in a yoke 56 and is adapted for reciprocal coaxialmovement within the fixed section 20 of endoscopic portion 18. Aflexible cable 58 having opposed proximal and distal ends 60 and 62 ismounted, at the distal end 62 thereof, to yoke 56, and at the proximalend 60 thereof, to the distal end 64 of a plunger member 66. Plungermember 66 includes a head portion 68 which is retained in a pivotal clipassembly 70 having opposed complimentary sections 72 and 74. Opposedclip sections 72 and 74 are mounted to one another and are disposedwithin a port 76 formed in the pivoting handle 16 of handle portion 12.Movements of pivoting handle 16 thus causes corresponding coaxialmovements of plunger member 66.

Referring now to FIGS. 2 and 3, the endoscopic surgical instrument 10 ofthe subject invention further includes a linkage assembly which isassociated with the endoscopic portion 18 and handle portion 12 forpivoting the articulating portion 22 thereof. The linkage assemblyincludes an elongated push rod 78 having opposed proximal and distalends 80 and 82, with the proximal end 80 thereof being formed with anaperture 84 for receiving a pin 86. In addition, rod 78 includes amounting flange 88 provided on the distal end 82 thereof which includesan aperture 90 for receiving a pin 92. Pin 92 functions to pivotallyconnect a link rod 94 to mounting flange 88 through an aperture 96disposed in the proximal end of link rod 94. Link rod 94 is providedwith an aperture 98 in the distal end thereof, through which a pin 100extends to be pivotally mounted in an aperture 102 which is provided inarticulating section 22 of endoscopic portion 18. The linkage mechanismof the subject invention further includes an elongated gear rack member104 which is capable of being reciprocated in an axial direction. Gearrack member 104 is formed with circumferential gear teeth 106 and anaxial bore 107 which is provided to permit flexible cable 58 to extendthrough so as to reach plunger member 66. Gear rack member 104 isfurther provided with a mounting flange 108 having an aperture 109. Pin86 extends through aperture 109 and is mounted in aperture 84 so as toconnect rack member 104 to the proximal end 80 of push rod 78. Anannular pinion gear 110 is mounted on a shaft 112 associated with handleportion 12. Pinion gear 110 meshes with the circumferential gear teeth106 on rack member 104. Rotation of pinion gear 110 is achieved byrotating a pair of opposed wing members 114 and 116 which are mounted onthe opposed ends of shaft 112.

The endoscopic surgical instrument 10 of the subject invention furthercomprises a mechanism for rotating the endoscopic portion 18 about itslongitudinal axis relative to handle portion 12. This mechanismcomprises an annular bushing 120 that is concentrically mounted within arotatable collar 122 mounted within the stepped bore 40 formed in handleportion 12. Bushing 120 is maintained against collar 122 by a coiledspring 124 disposed in a section of bore 40. Spring 124 acts to biasbushing 120 toward the proximal end of the surgical instrument 10. Theproximal end 27 of fixed section 20 of endoscopic portion 18 extendsthrough bushing 120 and is mounted therein for rotation.

Referring to FIGS. 3-6, the operation of the cooperating jaws 30 and 32of tool head 28 is accomplished by moving the pivoting handle 16 asshown in FIG. 3. Upon moving the pivoting handle 16, the head 68 ofplunger member 66 travels axially causing cable 58 to translate. Inorder to close the cooperating jaws 30 and 32, which are normally openas illustrated in FIG. 4, the pivoting handle 16 is squeezed by thesurgeon, thereby causing the plunger member 66 to pull cable 58 in aproximal direction. The movement of cable 58 causes a correspondingaxial movement of yoke 56, as shown by the indicator arrow in FIG. 6. Inparticular, the movement of yoke 56 causes pin 55 to cam proximallywithin slots 53 and 54 of jaws 30 and 32 respectively, so as to causejaws 30 and 32 to close. Turning now to FIGS. 7-10, the pivotingmovement of the articulating section 22 of endoscopic portion 18 isaccomplished by rotating wing members 114 and 116 to a desired angularposition. More particularly, a detent engaging member 118 is coaxiallymounted on shaft 112 along with wing members 114 and 116 which can berotatably engaged in various PG,12 predetermined positions indicated onhandle portion 12 which correspond to 30°, 60°, or 90° of rotationdepending upon the surgical procedure being preformed.

To pivot the tool head 28 angularly with respect to the longitudinalaxis of the endoscopic portion 18, the wing members 114 and 116 arerotated in a counter-clockwise direction. This counter-clockwiserotation causes pinion gear 110 to rotate on shaft 112 in acounter-clockwise direction. Simultaneously, gear rack member 104advances proximally within stepped bore 40 causing the elongated pushrod 78 to advance proximally along the longitudinal axis of encloseopicportion 18. Link member 94 is pulled in a generally proximal direction,as shown by the indicator arrow running parallel to link member 94 inFIG. 7, causing the articulating section 22, and the associated toolhead 28, to pivot in an angular direction about pin 24. Once thearticulating section 22 is in a desired angular position relative to thelongitudinal axis of endoscopic portion 18, the cooperating jaws 30 and32 may be opened or closed by operating the pivoting handle 16 in handleportion 12 as discussed previously.

Turning now to FIGS. 11-15, an alternate embodiment of the tool head 28of the endoscopic surgical instrument 10 of the subject invention isillustrated. In this embodiment, the tool head 28 includes cooperatingdissector jaws 150, 152 which are pivotally mounted on the articulatingsection 22 of endoscopic portion 18. Furthermore, dissector jaws 150,152 are provided with camming slots 154, 156 respectively formed in thedistal ends thereof. As in the preferred embodiment, camming pin 55 isaccommodated within slots 154, 156 and slides in response to axialmovements of yoke member 56 when the pivoting handle 16 is operated toopen and close jaws 150 and 152.

Referring to FIGS. 14 and 15, when link rod 94 is moved in a generallyproximal direction, tool head 28 pivots relative to the longitudinalaxis of endoscopic portion 18. Upon reaching a desired angular position,the cooperating dissector jaws 150 and 152 may be opened or closed byoperating pivoting handle 16 of handle portion 12. Moreover, whenpivoting handle 16 is operated, cable 58, which extends through thediverging bore 25 formed in pivot pin 24, pulls on yoke member 56causing pin 55 to slide within slots 154 and 156, thereby opening orclosing the dissector jaws 150 and 152.

Turning now to FIG. 16, an alternate endoscopic surgical instrument 200of the subject invention is illustrated. Surgical instrument 200comprises a handle portion 202 configured as a pistol-grip, and anendoscopic portion 204. Endoscopic portion 204 includes a fixed tubularsection 206 having opposed distal and proximal ends 208 and 210, and anarticulating section 212 which is pivotally connected to the fixedsection 206 by a pivot pin 2 14 disposed adjacent to the distal end 208thereof. Surgical instrument 200 further comprises an elongated paddle216 which depends from articulating section 212 and which is intendedfor use as a retractor tool during surgical procedures.

An electrocautery connector 213 is provided and extends from the handleportion 202 for cauterization of tissue at the surgical site during thesurgical procedure. The connector 213 is in electrical connection withthe tool 216. In order to protect the surgeon who is using the devicefrom electrical shock, the handle 202 is preferably constructed of arigid non-conducting material which renders the apparatus lightweightand electrically insulated.

Referring to FIG. 17, surgical instrument 200 is provided with a linkageassembly that is similar to the assembly provided in the preferredembodiment of the subject invention. It comprises an elongated push rod2 18 which is pivotally connected to a link member 220 by a pin 222.Link member 220 is pivotally connected to articulating section 212 by apin 224. Referring to FIG. 18, the linkage assembly also includes anannular pinon gear 226 which is mounted for rotation on a shaft 228provided in handle portion 202. Wing members 230 are coaxially mountedon shaft 228 for rotating pinon gear 226. Pinon gear 226 meshes with areciprocating gear rack member 232 disposed within the stepped bore 234which is formed in handle portion 202. Furthermore, gear rack member 232is connected to elongated push rod 218.

Surgical instrument 200 also includes an assembly for rotating theendoscopic portion 204 about its longitudinal axis. The rotatingassembly includes an annular collar 236 which is disposed within a port238 formed in bore 234, and an annular bushing 240 concentricallydisposed within the annular collar 236. Bushing 240 is provided foraccommodating the proximal end of endoscopic portion 206, which ismounted therein for rotation. A coiled spring 242 is disposed withinstepped bore 234 for biasing bushing 240 in a proximal direction so asto maintain it within collar 236.

Referring now to FIG. 19, to lower the retractor paddle 216 into aposition parallel to the longitudinal axis of endoscopic portion 204,the wing members 230 are rotated in a clockwise direction. Thisclockwise rotation of wing members 230 causes a clockwise rotation ofpinion gear 226 about shaft 228. Consequently, gear rack member 232 iscaused to advance distally along the axis of endoscopic portion 204.Push rod 218 advances distally within the fixed section 206 ofendoscopic portion of 204. Upon advancing, push rod 218 causes linkmember 220 to move in a generally distal direction, thereby causingpaddle 216 to pivot downwardly, as shown by the indicator arrow in FIG.19.

Turning to FIGS. 20 and 21, an alternate endoscopic surgical instrument300 of the subject invention is illustrated. Surgical instrument 300 isstructurally similar to the preferred embodiment of the subjectinvention. However, the range of operability of the tool head 28 ofsurgical instrument 300 is distinct in that it can be pivoted in ahorizontal plane with respect to the endoscopic portion 18 of surgicalinstrument 300.

In this embodiment, the components and function of the linkage assemblyremains essentially the same as in the preferred embodiment. Inparticular. annular pinion gear 110 which is mounted on a shaft 112 inhandle portion 12, meshes with the circumferential gear teeth 106 ofgear rack member 104. The proximal end 80 of the elongated push rod 78is pivotally connected to the flange 108 of gear rack member 104 and thedistal end 82 of the elongated push rod 78 is pivotally connected tolink member 94 by a pin 92. The linkage assembly of surgical instrument300 is operatively connected to an articulating section 302.Articulating section 302 includes a slotted distal portion 304 and aproximal portion 306 having a bore 308 for receiving pivot pin 24. Acleat 3 10 extend outwardly from the proximal portion 306 ofarticulating section 302 and includes an aperture 312 for receiving apivot pin 314 which connects the link member 94 to the articulatingsection 302.

To pivot the tool head 28 angularly, in a horizontal plane, with respectto the longitudinal axis of the endoscopic portion 18, the wing members114 and 116 are rotated. Simultaneously, gear rack member 104 advanceswithin stepped bore 40 causing the elongated push rod 78 to advancealong the longitudinal axis of endoscopic portion 18. Movement of theelongated push rod 78 causes link member 94 to pivot in such a manner soas to cause the articulating section 302, and the associated tool head28, to pivot in an angular direction about pivot pin 24. Once thearticulating section 302 is in a desired angular position relative tothe longitudinal axis of endoscopic portion 18, the cooperating jaws 30and 32 may be operated by manipulating the pivoting handle 16 in handleportion 12 as discussed hereinabove.

The endoscopic surgical instrument of the subject invention is compact,lightweight and easy to use. It is intended to enable the surgeon to usethe instrument with one hand, thus freeing the other hand forperformance of other surgical tasks.

To the extent not already indicated, it also will be understood by thoseof ordinary skill in the art that any one of the various specificembodiments herein described and illustrated may be further modified toincorporate features shown in other of the specific embodiments.

Although the endoscopic surgical instrument of the subject invention hasbeen described with respect to a preferred embodiment, it is apparentthat changes may be made to the invention without departing from thespirit and scope of the invention as defined by the appended claims.

What is claimed is:
 1. An endoscopic surgical apparatus comprising:ahandle portion; an endoscopic portion including an elongated tubularsection defining a longitudinal axis and having opposed proximal anddistal ends, the proximal end of said tubular section extending fromsaid handle portion, and an articulating section pivotally connected tosaid tubular section adjacent the distal end thereof; tool meansdepending from said articulating section of said endoscopic portion forperforming a surgical task; a linkage mechanism including at least onereciprocating member associated with said handle portion and saidendoscopic portion for pivoting said articulating section to anarticulated position at an angle to the longitudinal axis of saidtubular section; and means for actuating said tool means at least whensaid articulating section is disposed at an angle to said longitudinalaxis of said tubular section.
 2. A surgical apparatus as recited inclaim 1 wherein said articulating section is pivotable about a pivotpoint within a 90° sector of rotation.
 3. A surgical apparatus asrecited in claim 1 wherein said linkage mechanism comprises a pluralityof reciprocating members operable by a rotating member disposed in saidhandle portion to control the movement of said articulating section. 4.A surgical apparatus as recited in claim 3 wherein said plurality ofreciprocating members includes first, second, and third reciprocatingmembers.
 5. A surgical apparatus as recited in claim 4 wherein saidrotating member includes an annular pinion gear mounted for rotation insaid handle portion and said first reciprocating member is formed with agear rack for meshing with said pinion gear, said first reciprocatingmember being movable along the longitudinal axis of said endoscopicportion in response to rotation of said pinion gear.
 6. A surgicalapparatus as recited in claim 5 wherein said second reciprocating memberis an elongated push rod extending through said tubular section havingopposed proximal and distal ends, the proximal end of which is connectedto said first reciprocating member, said push rod being movable in anaxial direction in response to axial movements of said firstreciprocating member.
 7. A surgical apparatus as recited in claim 6wherein said third reciprocating member is a link rod having opposedends with one of said ends pivotally connected to the distal end of saidpush rod and the opposed end pivotally connected to said articulatingsection of said endoscopic portion.
 8. A surgical apparatus as recitedin claim 7 wherein rotation means are included in said handle portionfor revolving said endoscopic portion about the longitudinal axisthereof.
 9. A surgical apparatus as recited in claim 8 wherein saidrotation means comprises a rotatable annular collar and an annularbushing coaxially mounted in said rotatable collar and adapted forengaging the proximal end of said fixed section of said endoscopicportion.
 10. A surgical apparatus as recited in claim 9 wherein anelectrocautery connector is mounted in said handle portion forcauterization of tissue at a surgical site.
 11. A surgical apparatus asrecited in claim 10 wherein said tool means is a paddle for performingretraction tasks.
 12. A surgical apparatus as recited in claim 10wherein said handle portion includes a fixed handle and a pivotinghandle.
 13. A surgical apparatus as recited in claim 12 wherein saidtool means comprises a pair of cooperating jaws for performing graspingtasks.
 14. A surgical apparatus as recited in claim 13 wherein saidcooperating jaws are operatively connected to said pivoting handle. 15.A surgical apparatus as recited in claims 14 wherein said cooperatingjaws and said pivoting handle are operatively connected to one anotherby a flexible cable assembly.
 16. A surgical apparatus comprising:ahandle portion including at least one pivoting handle; an endoscopicportion including an elongated tubular section defining a longitudinalaxis and having opposed proximal and distal ends, the proximal end ofsaid tubular section extending from said handle portion, and anarticulating section pivotally connected to said tubular sectionadjacent the distal end thereof; a pair of cooperating jaws dependingfrom said articulating section of said endoscopic portion; a linkagemechanism associated with said handle portion and said endoscopicportion for pivoting said articulating section to an articulatedposition at an angle to the longitudinal axis of said tubular section;rotation means for rotating said cooperating jaws about the longitudinalaxis of said endoscopic portion relative to said handle portion; andmeans for operatively connecting said cooperating jaws and said at leastone pivoting handle, whereby movement of said at least one pivotinghandle will cause said cooperating jaws to open and close.
 17. Asurgical apparatus as recited in claim 16 wherein said connecting meanscomprises a cable assembly.
 18. A surgical apparatus as recited in claim16 wherein said articulating section is pivotable about a pivot pointwithin a 90 ° sector of rotation.
 19. A surgical apparatus as recited inclaim 16 wherein said linkage mechanism comprises a plurality ofreciprocating members operable by a rotating member disposed in saidhandle portion to control the movement of said articulating section. 20.A surgical apparatus as recited in claim 19 wherein said plurality ofreciprocating members includes first, second, and third reciprocatingmembers.
 21. A surgical apparatus as recited in claim 20 wherein saidrotating member includes an annular pinion gear mounted for rotation insaid handle portion and said first reciprocating member is formed with agear rack for meshing with said pinion gear, said first reciprocatingmember being movable along the longitudinal axis of said endoscopicportion in response to rotation of said pinion gear.
 22. A surgicalapparatus as recited in claim 21 wherein said second reciprocatingmember is an elongated push rod extending through said tubular sectionhaving opposed proximal and distal ends, the proximal end of which isconnected to said first reciprocating member, said push rod beingmovable in an axial direction in response to axial movements of saidfirst reciprocating member.
 23. A surgical apparatus as recited in claim22 wherein said third reciprocating member is a link rod having opposedends with one of said ends pivotally connected to the distal end of saidpush rod and the opposed end pivotally connected to said articulatingsection of said endoscopic portion.
 24. A surgical apparatus as recitedin claim 23 wherein said rotation means comprises a rotatable annularcollar and an annular bushing coaxially mounted in said rotatable collarand adapted for engaging the proximal end of said fixed section of saidendoscopic portion.
 25. A surgical apparatus as recited in claim 24wherein a spring is mounted in said handle portion for maintaining saidannular bushing within said rotatable collar.
 26. A surgical apparatuscomprising:a handle portion; an endoscopic portion including anelongated tubular section defining a longitudinal axis and havingopposed proximal and distal ends, the proximal end of said tubularsection extending from said handle portion, and an articulating sectionpivotally connected to said tubular section adjacent the distal endthereof; tool means depending from said articulating section of saidendoscopic portion for performing surgical tasks; a linkage mechanismassociated with said handle portion and said endoscopic portion forpivoting said articulating section to an articulated position at anangle to the longitudinal axis of said tubular section; and rotationmeans for rotating said endoscopic portion about the longitudinal axisthereof relative to said handle portion.
 27. A surgical apparatus asrecited in claim 26 wherein said tool means comprises retractor meansfor performing retraction tasks.
 28. A surgical apparatus as in claim 27wherein said retractor memos comprises at least one paddle dependingfrom said articulating section.
 29. A surgical apparatus as recited inclaim 26 wherein said articulating section is pivotable about a pivotpoint within a 90° sector of rotation.
 30. A surgical apparatus asrecited in claim 27 wherein said linkage mechanism comprises a pluralityof reciprocating members operable by a rotating member disposed in saidhandle portion to control the movement of said articulating section. 31.A surgical apparatus as recited in claim 30 wherein said plurality ofreciprocating members includes first, second, and third reciprocatingmembers.
 32. A surgical apparatus as recited in claim 31 wherein saidrotating member includes an annular pinion gear mounted for rotation insaid handle portion and said first reciprocating member is formed with agear rack for meshing with said pinion gear, said first reciprocatingmember being movable along the longitudinal axis of said endoscopicportion in response to rotation of said pinion gear.
 33. A surgicalapparatus as recited in claim 32 wherein said second reciprocatingmember is an elongated push rod extending through said tubular sectionhaving opposed proximal and distal ends, the proximal end of which isconnected to said first reciprocating member, said push rod beingmovable in an axial direction in response to axial movements of saidfirst reciprocating member.
 34. A surgical apparatus as recited in claim33 wherein said third reciprocating member is a link rod having opposedends with one of said ends pivotally connected to the distal end of saidpush rod and the opposed end pivotally connected to said articulatingsection of said endoscopic portion.
 35. A surgical apparatus as recitedin claim 34 wherein said rotation means comprises a rotatable annularcollar and an annular bushing coaxially mounted in said rotatable collarand adapted for engaging the proximal end of said fixed section of saidendoscopic portion.
 36. A surgical apparatus as recited in claim 35wherein a coiled spring is mounted in said handle portion formaintaining said annular bushing within said rotatable collar.
 37. Anendoscopic surgical apparatus comprising:a handle portion; an endoscopicportion including an elongated tubular section defining a longitudinalaxis and having opposed proximal and distal ends, the proximal end ofsaid tubular section extending from said handle portion, and anarticulating section pivotally connected to said tubular sectionadjacent the distal end thereof; jaw means depending from saidarticulating section of said endoscopic portion for performing asurgical task; a linkage mechanism including at least one reciprocatinglink member extending from said handle portion through said endoscopicportion for pivoting said articulating section relative to thelongitudinal axis of said tubular section; and means cooperating withsaid handle portion for moving said jaw means between open and closedpositions.
 38. An endoscopic surgical apparatus comprising:a handleportion; an endoscopic portion including an elongated tubular sectiondefining a longitudinal axis and having opposed proximal and distalends, the proximal end of said tubular section extending from saidhandle portion and an articulating section movably connected to saiddistal end of said tubular section; tool means operatively connected tosaid articulation section adjacent a distal end thereof; a linkagemechanism including a plurality of reciprocating link members associatedwith said handle portion and said endoscopic portion for pivoting saidtool means about an axis transverse to the longitudinal axis of saidtubular section to a predetermined number of positions; and meansdisposed at least partially within said endoscopic portion for actuatingsaid tool means.
 39. A surgical apparatus comprising:a handle portion;an endoscopic portion including an elongated tubular section defining alongitudinal axis and having opposed proximal and distal ends, theproximal end of said tubular section extending from said handle portionand an articulating section pivotably connected to said distal end ofsaid tubular section; retractor means extending from said articulatingsection adjacent a distal end thereof for performing a surgical task;means associated with said handle portion and said endoscopic portionfor pivoting said articulating section about an axis orthogonal to thelongitudinal axis of said tubular section; and means for rotating saidretractor means about said longitudinal axis of said tubular sectionrelative to said handle portion.
 40. An apparatus as recited in claim 39wherein said pivoting means comprises a linkage mechanism.
 41. Anapparatus as recited in claim 39, further comprising means forcontrolling movement of said retractor means.
 42. An apparatus asrecited in claim 41 wherein said pivoting means comprises a linkagemechanism.
 43. An apparatus as recited in claim 41 wherein saidarticulating section is pivotable about a pivot point within a 90°sector of rotation.
 44. An apparatus as recited in claim 39, furthercomprising means for rotating said retractor means about thelongitudinal axis of said endoscopic portion.
 45. An endoscopic surgicalapparatus comprising:a handle portion; an endoscopic portion includingan elongated tubular section defining a longitudinal axis and havingopposed proximal and distal ends, the proximal end of said tubularsection extending from said handle portion, and an articulating sectionpivotally connected to said tubular section by a horizontally orientedpivot pin disposed adjacent the distal end thereof; tool means dependingfrom said articulating section of said endoscopic portion for performinga surgical task; a reciprocating linkage mechanism including at leastone link member associated with said handle portion and said endoscopicportion for pivoting said articulating section to an articulatedposition about an axis orthogonal to the longitudinal axis of saidtubular section; and means for actuating said tool means at least whensaid articulating section is disposed at an angle to said longitudinalaxis of said tubular section.
 46. An endoscopic apparatus comprising:ahandle portion; an endoscopic portion including an elongated tubularsection defining a longitudinal axis and having opposed proximal anddistal ends, the proximal end of said tubular section extending fromsaid handle portion, and an articulating section pivotally connected tosaid tubular section by a vertically oriented pivot pin disposedadjacent the distal end thereof; a retractor mechanism depending fromsaid articulating section of said endoscopic portion for performing asurgical task; and a linkage mechanism including at least onereciprocating member associated with said handle portion and saidendoscopic portion for pivoting said articulating section to anarticulated position about an axis orthogonal to the longitudinal axisof said tubular section.
 47. A surgical apparatus as recited in claim 1wherein said retractor mechanism includes at least one retractor member.